Individual
TAMARA BEALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
6611 GULTON CT NE, ALBUQUERQUE, NM 87109-4407
(505) 296-3965
(505) 323-9430
Mailing address
6611 GULTON CT NE, ALBUQUERQUE, NM 87109-4407
(505) 296-3965
(505) 323-9430
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M1919
—
NM
Enumeration date
09/30/2009
Last updated
09/30/2009
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